Long-term outcomes of two first-generation trabecular micro-bypass stents (iStent) with phacoemulsification in primary open-angle glaucoma: eight-year results  

作　　者：Ali Salimi Harrison Watt Paul Harasymowycz 

机构地区：[1]Department of Ophthalmology,Faculty of Medicine,McGill University,Montreal,QC,Canada [2]Montreal Glaucoma Institute,Montreal,QC,Canada [3]Faculty of Medicine,McGill University,Montreal,QC,Canada [4]Department of Ophthalmology,University of Montreal,4135 de Rouen,Montreal,QC H1V1G5,Canada.

出　　处：《Eye and Vision》2023年第4期29-40,共12页眼视光学杂志（英文）

摘　　要：Background:The short-and medium-term outcomes of iStent have been extensively studied;however,only few studies have investigated its long-term outcomes.Here,we assessed the long-term efficacy and safety of two iStents with concomitant cataract surgery in glaucomatous eyes while also evaluating measures of disease stability using vis-ual field and optical coherence tomography(OCT)of the optic nerve and the macula throughout eight years of follow-up.Methods:This longitudinal,single-center consecutive case series included glaucomatous eyes that underwent implantation of two first-generation trabecular micro-bypass stents(iStent)with concomitant cataract surgery.Eight-year efficacy outcomes included mean intraocular pressure(IOP)and medications,as well as surgical success.Eight-year safety outcomes included best-corrected visual acuity(BCVA),visual field mean deviation(VF-MD),cup-to-disc ratio(CDR),retinal nerve fiber layer(RNFL)thickness,ganglion cell-inner plexiform layer(GC-IPL)thickness,and adverse events.Results:A total of 62 eyes with primary open-angle glaucoma(POAG)were included.At eight years postoperative,IOP reduced by 26%from 19.2±3.9 mmHg preoperatively to 14.2±2.4 mmHg(P<0.001),91.1%of eyes achieved IOP≤18 mmHg(vs.51.6%preoperatively),69.6%of eyes achieved IOP≤15 mmHg(vs.14.5%preoperatively),and 25%of eyes achieved 1OP≤12 mmHg(vs.1.6%preoperatively).Medication use decreased by 17.9%from 2.8±1.1 preoperatively to 2.3±1.2(P=0.018).Surgical success rate was 90%,as six eyes underwent subsequent glaucoma surgeries.Safety measures of BCVA,CDR,RNFL thickness and GC-IPL thickness remained stable through eight years postoperative.VF-MD remained stable until postoperative year five and subsequently progressed according to the natural history of glaucomatous disease.Conclusions:Implantation of two iStents with concomitant cataract surgery is an effective and safe treatment option for surgery-naive POAG eyes,evidenced by significant IOP and medication reductions,reasonable surgical suc-cess,and favorable

关 键 词：Minimally invasive glaucoma surgery MiGS Trabecular micro-bypass stent iStent Glaucoma Cataract surgery Long-term outcomes 

分 类 号：R779.6[医药卫生—眼科]